Behavior Checklist for Adults

Adult's Name

0=Never 1=Rarely 2=Once in a While 3=Often 4=Almost Always

1.) I was easily distracted.

2.) I made careless mistakes or had trouble paying close attention details or make careless to details.

3.) I fidgeted (with my hands or feet) or squirmed in my seat.

4.) I had trouble keeping my attention focused at school or during fun activities.

5.) It was hard for me to sit still for long: I left my seat when I was not supposed to.

6.) I didn't listen when people spoke directly to me.

7.) I felt restless.

8.) I had trouble following through on instructions and failed to finish things I started.

9.) I was noisy and had difficulty doing things quietly.

10.) I had difficulty organizing tasks and activities.

0=Never 1=Rarely 2=Once in a While 3=Often 4=Almost Always

11.) I was always on the go, as if driven by a motor.

12.) I avoided, disliked, or was reluctant to engage in work that requires required sustained mental effort.

13.) I talked too much.

14.) I lost things necessary for tasks or activities (lists, pencils, cell phone, keys, books, tools, etc).

15.) I blurted out answers before questions had been completed.

16.) I had trouble awaiting my turn.

17.) I was forgetful in my daily activities.

18.) I interrupted or intruded on others accidentally.